Organization
S.H.A.P.E SOLUTIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROLYN R. YOUNG (PRESIDENT)
(202) 215-9252
Entity
Organization
Contact information
Practice address
12237 FAIRFIELD HOUSE DR APT 311, FAIRFAX, VA 22033-3953
(202) 215-9252
Mailing address
3448 ANDREW CT APT 102, LAUREL, MD 20724-2359
(202) 215-9252
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106E00000X
Assistant Behavior Analyst
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y520108734422
NONE
MD
Enumeration date
10/05/2018
Last updated
10/05/2018
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